PURPOSE:To report outcomes of suprachoroidal hemorrhage (SCH). METHODS:Retrospective nonrandomized study of eyes with SCH from two sites (January 1, 2013-December 31, 2022). The primary outcome was the 6-month change in visual acuity (VA). Multivariable analysis was performed, as well as a comparison of matched eyes with and without systemic steroids. RESULTS:Overall, 143 eyes of 143 patients (mean age 70.8 years, 52.4% male) were included, with 72 perioperative, 24 traumatic, and 47 spontaneous SCH cases. The mean (SD) presenting VA was 2.07 (0.92) logMAR. 87 (60.8%) were managed nonsurgically, 24 (16.8%) underwent drainage, and 32 (22.4%) underwent drainage and vitrectomy; 36 (25.2%) received systemic steroids. At 6 months, the mean (SD) change in VA from presentation was -0.41 (0.84) logMAR. 102 eyes (71.3%) achieved anatomic success (complete retinal attachment). Concurrent retinal detachment was associated with worse VA change and anatomic success in multivariable analysis ( P < 0.05). In the matching analysis, eyes receiving systemic steroids were more likely to achieve ≥ 3-line gain in VA than matched eyes without systemic steroids (77.8% vs. 55.3%, P = 0.047). CONCLUSION:The visual prognosis of eyes with SCH remains guarded. Systemic steroids may be associated with a modest benefit for visual outcomes. Concurrent retinal detachment portends worse outcomes.
PURPOSE:To characterize the surgical management and outcomes of large high myopic macular holes (HMMHs). METHODS:Global multicenter retrospective case series of HMMHs with minimum linear diameter ≥ 400 µ m undergoing surgery between 2013 and 2023 with follow-up ≥ 3 months. The main outcome measure was the HMMH closure rate at postoperative Month 3. RESULTS:Four hundred and ninety-nine cases of 463 patients from 37 surgeons were included, with mean ± SD age 58.3 ± 12.2 years, 77.0% female, 77.4% primary, 22.6% refractory, and mean ± SD follow-up 18.8 ± 20.2 months. The mean ± SD (range) minimum linear diameter was 649 ± 280 (400, 2,759) µ m. Surgery techniques included 127 internal limiting membrane peels, 285 internal limiting membrane flaps, 19 amniotic membrane transplantations, 36 autologous retinal transplantations, and 32 others. The postoperative Month 3 closure rate for all cases was 72.4%. Closure rates significantly decreased with greater CLOSE Study Group size classification for HMMHs treated with internal limiting membrane peeling or internal limiting membrane flap ( P = 0.006) but not for HMMHs treated with amniotic membrane transplantations or autologous retinal transplantations ( P > 0.05). Visual acuity significantly increased from baseline to each follow-up time point among all eyes, with a final mean ± SD change in visual acuity of -0.29 (0.55) logMAR (+14.5 early treatment diabetic retinopathy study letters), which did not significantly differ by surgery type. CONCLUSION:High myopic macular hole closure rates are lower than those reported for macular holes in nonhighly myopic eyes, but most eyes can still achieve anatomical closure and meaningful visual acuity gains when treated with the appropriate technique.
PURPOSE:The authors report their long-term outcomes and potential complications after using the sutureless intrascleral fixation (SIS) technique to repair patients after complicated cataract surgery. METHODS:This is a retrospective cohort study of patients who had SIS surgery due to retained lens fragments from January 2015 to January 2025 at Associated Retinal Consultants. Charts were manually reviewed to ensure consistent SIS technique was used in all participants, were followed for at least 6 months, and to analyze main outcome measures. RESULTS:Hundred and forty nine patients met inclusion criteria with an average follow-up time of 918 days. Most patients had the MA60AC lens (96 patients) or ZA9003 lens (32 patients) placed. Three patients and four patients had the AR40 and CT Lucia secondary intraocular lens (IOL), respectively. Endophthalmitis rate was 2.0%, all cases in the MA60AC group, with an average time of 1,469 days, 11% had IOL dislocations at an average of 442 days, 5% had vitreous hemorrhage at an average of 441 days, and 4% had a retinal detachment at an average of 707 days. No difference among IOL types was found between the anatomical outcomes analyzed. CONCLUSION:After successful SIS IOL implantation, the authors can see patients develop endophthalmitis, vitreous hemorrhage, retinal detachment, and IOL dislocation.
BackgroundThe hyaloid artery is a branch of the ophthalmic artery and part of the fetal hyaloid vascular system; failure of these fetal vessels to regress can lead to a persistent hyaloid artery (PHA). PHA can induce complications, including amblyopia, cataracts, glaucoma, vitreous hemorrhage, and retinal detachment. We present a case of vitreous hemorrhage secondary to traction of the PHA in an infant treated for threshold retinopathy of prematurity (ROP).Case PresentationA 660-g female infant was born at 23 weeks of gestation and was found to have bilateral Stage 3 Zone 2 ROP with plus disease, prompting laser photocoagulation to the avascular retina. Six weeks after this treatment, the patient was found to have a vitreous hemorrhage requiring vitrectomy. The etiology of the hemorrhage was thought to be secondary to traction on the PHA after laser photocoagulation treatment. She developed subsequent anisometropic myopia and amblyopia, for which she continues care.ConclusionsVitreous hemorrhage is a rare but severe complication of PHA. This unique case of traction on the PHA with subsequent vitreous hemorrhage after routine treatment of ROP highlights the importance of considering PHA in the management of ROP.
